US8393329B2 - Pediatric lumbar puncture positioning device - Google Patents
Pediatric lumbar puncture positioning device Download PDFInfo
- Publication number
- US8393329B2 US8393329B2 US13/045,331 US201113045331A US8393329B2 US 8393329 B2 US8393329 B2 US 8393329B2 US 201113045331 A US201113045331 A US 201113045331A US 8393329 B2 US8393329 B2 US 8393329B2
- Authority
- US
- United States
- Prior art keywords
- patient
- board
- blocks
- infant
- infant patient
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G2200/00—Information related to the kind of patient or his position
- A61G2200/10—Type of patient
- A61G2200/14—Children
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G2200/00—Information related to the kind of patient or his position
- A61G2200/30—Specific positions of the patient
- A61G2200/38—Specific positions of the patient kneeling
Definitions
- Lumbar punctures, or spinal taps are indicated for a variety of reasons.
- lumbar puncture is indicated in any infant with symptoms suggestive of meningitis (seizures, intractable vomiting and unexplained fever), and in the evaluation of neonatal intracranial bleeding.
- the infant must be held firmly in the lateral decubitus or sitting position.
- a 22 to 25 gauge needle is inserted into the L3-L4 or L4-L5 interspace. A sample of cerebrospinal fluid is collected for diagnostic testing.
- the lumbar puncture procedure is carried out by a physician with the aid of one or more other persons who hold the infant in a side-laying, sitting position with the back arched. This position provides the physician access to the spinal region from which the cerebrospinal fluid will be drawn. Stable, proper positioning of the patient is critical to a successful lumbar puncture. If the patient's back is over-arched, upward pressure can be exerted on the infant's diaphragm resulting in a compromise of the patient's respiratory status. Similarly, neurologic injury or unnecessary trauma can occur if the needle is inserted in the incorrect location.
- the device includes a board, a positioning member adjustably coupled to the board, and a locking device coupled to the positioning member for locking the positioning member in a position relative to one or both of the board or the patient.
- the positioning member is configured to induce the patient into a clinically preferred position for performing a lumbar puncture on the patient.
- FIG. 1 is top plan view illustrating a lumbar puncture positioning device in accordance with an exemplary implementation of the present disclosure.
- FIG. 2 is another top plan view of the device shown in FIG. 1 .
- FIG. 3 is a perspective view of the device shown in FIG. 1 .
- FIG. 4 is a top plan view illustrating a lumbar puncture positioning device in accordance with a second exemplary implementation of the present disclosure.
- FIG. 5 is a perspective view of the device shown in FIG. 4 .
- FIG. 6 is a top plan view of the device shown in FIG. 4 .
- FIG. 7 is a partially-exploded, perspective view of the device shown in FIG. 4 .
- FIG. 8 is an elevation view of part of a lumbar puncture positioning device in accordance with the present disclosure.
- FIG. 9 is a perspective view of the device shown in FIG. 8 in use with a patient.
- the devices include a board, a positioning device, a board interface, and an inducing device.
- the board may be any flat, planar base to which a variety of positioning devices may be attached.
- the instant interface between the board and the patient can be a thin layer of soft material, but the board needs to have sufficient rigidity in order to stabilize the patient during the performance of the procedure.
- the positioning device is one or more devices that place a patient in a clinically preferred position upon the board.
- the board interface is the device by which the positioning device may be connected to the board.
- the board interface is adjustable so that the positioning device can be placed in multiple positions around the board.
- the inducing device is the way by which the system mechanically adjusts the position of the patient into a clinically preferred position.
- the board and positioning members may comprise an anti-microbial material.
- a stable, clinically preferred position of the patient facilitates a successful lumbar puncture of an infant patients.
- upward pressure can be exerted on the infant's diaphragm resulting in a compromise of the patient's respiratory status.
- neurologic injury or unnecessary trauma can occur if the needle is inserted in the incorrect location. Accordingly, a clinically preferred position facilitates access to the proper regions of the spine without increased risk of compromising the respiratory status of the patient.
- the device 10 includes a rigid board 12 and a positioning device or positioning members made of straps 14 , 16 , 18 and 20 .
- Board 12 is primarily composed of a rigid material so that it provides a hard, substantially inflexible base.
- the board has dimensions of about 12′′ ⁇ 18′′ ⁇ 24′′ and is composed of polypropylene.
- Board 12 need not be solid or formed of material of sufficient density for repeated use.
- the board may be formed of thinner and lighter material such that it may be inexpensive and intended for a single use.
- the board 12 may comprise a plurality of segments that may be separated or folded for storage.
- the positioning device is comprised of four straps 14 , 16 , 18 , and 20 which are threaded, fed, or looped through the slits 30 and 33 in the board that serve as the board interface.
- the straps are made of Nylon and combine to partially surround the patient's body. The lower back of the patient is uncovered by the straps 14 , 16 , 18 , and 20 so that the operator can access the anatomy needed to perform a lumbar puncture.
- all or substantially all of the positioning device is made of inexpensive materials so that the positioning device can be affordably sold in sterilizable packaging and affordably disposed of after a single use. When positioning the patient, the sterile straps will allow a sterile field around the patient's relevant anatomy.
- the operator feeds each strap comprising the positioning device ( 18 and 20 ) through one of the set of board interface slits 30 and 31 .
- straps 14 and 16 may be fed through slits 33 .
- the board interface device further comprises an additional anchor for the positioning device: such as a hook and loop attachment, a snap or an adhesive region.
- the board interface may be adjustable.
- the straps may also be adjustably positioned by use of hook and loop or other attachment devices for coupling the straps to the board.
- the board interface is comprised of multiple slits 30 , 31 at multiple positions on the board 12 so that the straps 14 , 16 , 18 , and 20 can be placed in more than one location and accommodate multiple sizes of patients.
- the straps interface with the board through two sets of slits: one located at the posterior end of the patient and one located behind the neck at the anterior end of the sideways-laying patient.
- a single strap 18 or 20 is fed through a pair of slits 30 or 31 and anchored to the bottom side of the board 12 .
- the straps emerging from the posterior slits must be broad enough to cover a substantial amount of the patient's body.
- the straps taper off along their length into 1 inch straps 26 , 28 and a locking device shown as buckles 22 , 24 .
- the straps secure the patient by the operation of buckles that arrange the straps diagonally across the patient.
- the connection of the straps comprising the positioning device induces the patient to assume the clinically preferred position.
- the straps coordinate to securely position the patient.
- the board interface comprises other devices of attaching the straps comprising the positioning device.
- the Figures depict a board interface comprising four or more slits, but the board interface may accommodate any number of slits so as to maximize adjustability of the positioning device.
- the alternative slits may be placed in a concentric pattern such that the relative positions for corresponding slits are unchanged.
- the board and straps may accommodate patients of a wide variety of sizes.
- the operator may anchor the straps to the bottom of the board by a variety of devices before they emerge through the slits. This attachment may occur by clips, snaps, buttons, ties, or loops.
- the inducing device 32 is shown as the straps through which tension is applied to the patient through the fastening of the straps 18 , 20 to the frontal straps 14 , 16 .
- the patient By tightening the buckles between the broad posterior straps 18 , 20 and the frontal straps 14 , 16 , the patient is induced into a clinically preferred position as her shoulders and legs are bent around the point of intersection of the straps. Because the board itself is rigid and exerts an equal, or substantially equal, force back against the straps, the patient is thus effectively held immobile in the clinically preferred position.
- the board 112 is composed of primary layer 114 of substantially rigid, ridged cross-link closed-cell foam, with a second layer 116 of foam located on top of the primary layer.
- This second layer 116 of foam may have a laminated hook and loop fastener material (e.g. VELCRO-compatible) fabric top surface.
- VELCRO-compatible laminated hook and loop fastener material
- the board may be formed to the dimensions described in the previous Figures but, the board can be formed to any dimension that accommodates the placement of the positioning device.
- the positioning device or positioning members are comprised of three separate foam blocks 118 , 120 , and 122 .
- these blocks are composed of anti-microbial foam, though all clinically acceptable types of foam or other suitable material are contemplated.
- the foam has a minimum density of 1.7 lbs/ft 3 , a SAG Factor of at least 2.0, permits air flow of no more than 4.0 ft 3 /min, a tear strength of at least 2.0 lbs/linear inch, a tensile strength of 10.0-15.0 lbs/in 2 , elongation of 125-175%, resilience of at least 30% and Compression Set 90%, for 22 hours at 158° Fahrenheit of less than 10%.
- the positioning device is formed of materials that can be packaged in single use sterile packaging and produced affordably enough to be affordably disposable.
- the sterile foam blocks position the patient, they create a sterile field around the anatomy to perform the lumbar puncture.
- the positioning device is comprised of foam blocks that surround the patient and induce the patient into a clinically preferred position.
- the first block 120 (hereinafter the “Pivot Block”) is a foam block, shown as configured in the shape of an “8”, but any shape that will induce the patient into a clinically preferred position when appropriately interfaced with the board may be used.
- the Pivot Block's 120 round edge allows inducement of the patient to curl around the Pivot along their ventral side.
- the Pivot Block 120 is about 4.5′′ tall, but other heights that correspond to the width of the patient are permissible.
- the system may comprise a kit containing a number of Pivot Blocks in order to accommodate patients of a variety of sizes.
- the second block 122 (hereinafter the “Head Block”) is a foam block that is comprised out of substantially the same material as the Pivot Block 120 but formed to a different shape.
- the Head Block 122 contains a groove 124 for supporting the neck of the patient, which specifically supports neck flexion at a clinically recommended level.
- the third block 118 (hereinafter the “Lower Block”) is a foam block that is comprised out of substantially the same material as the Pivot Block 120 and Head Block 122 but formed to a different shape. Because the Lower Block 118 is not required to induce the patient to conform to a particular position or support critical anatomy, the Lower Block 118 need not conform to a specific shape. Instead, Lower Block 118 provides a guide to position the patient's lower body in the clinically preferred position.
- the blocks 118 , 120 , and 122 are arranged on the board such that when a patient is placed between them, the patient must automatically assume a clinically preferred position.
- the board 112 has markings 126 which assist with placement of the blocks into the correct formation.
- the Pivot Block 120 is placed in the center of the board, or any location where the subsequent blocks and the patient may be properly placed in relation thereto.
- the patient is then placed on the board and assumes the clinically preferred position by curling around the Pivot Block 120 .
- the Lower Block 118 is then placed behind the patient's legs, thereby compressing them between the Pivot Block 120 and the Lower Block 118 in the clinically preferred position.
- the Head Block 122 is then placed around the patient's upper body, taking care to ensure that the patient's neck is placed into the neck groove 124 . In this manner, the patient is conformed to the clinically preferred position.
- the foam blocks 118 , 120 and 122 comprising the positioning device are formed from a deformable material that can be packaged inside an airtight package wherein the package can be vacuum sealed so that the packaged foam blocks are substantially smaller.
- the board 112 may be formed from multiple components or otherwise jointed so that it can be folded or assembled from smaller pieces.
- both the positioning device and the board are packaged in containers small enough to ship as part of a lumbar puncture tray: such as a Covidien SENSI-TOUCHTM Lumbar Puncture Tray with Safety Components.
- the positioning device is one or more straps
- the straps and board 112 can be folded to fit on top of the tray.
- the board 112 and the positioning device can be formed out of materials commonly used to make disposable medical devices.
- the board interface may be comprised of VELCRO hooks which are attached to both the top and bottom of the Pivot Block 120 , Head Block 122 , and Lower Block 118 , along with the VELCRO-compatible fabric used as the top surface of the board.
- the SCOTCHMATE—SJ3526N or SJ3527N family of nylon hooks and loop reclosable fasteners may be used.
- the board interface comes into play when the various blocks are placed in their appropriate positions upon the board.
- Locking Strip 127 is shown as a piece of VELCRO-compatible fabric, formed to outline the profile of the positioning device.
- the Locking Strip 127 interfaces with the foam blocks comprising the positioning device.
- the operator secures the Locking Strip 127 firmly to the VELCRO-top 128 of the Head Block 122 .
- the Locking Strip 127 is stretched taught down to the Lower Block 118 and is firmly secured via its VELCRO-covered top 130 .
- the Locking Strip 127 is stretched over the patient's body to the Pivot Block 120 until a moderate degree of tension is acquired.
- the Locking Strip 127 is then firmly secured to the VELCRO-compatible top 132 of Pivot Block 120 in a manner similar to the Head Block 120 and Lower Block 118 , thus effectively securing the blocks around the patient and into an immobile structure which insures that the patient cannot shift out of the clinically preferred position while blocks 118 , 120 , and 122 and Locking Strip 127 are in place.
- the positioning device or positioning member may be primarily comprised of single device 310 that surrounds the patient to form a continuous point of contact.
- the positioning device further includes elements that support the patient and induce the patient to assume a clinically preferred position.
- the positioning device interfaces with the board 312 at an interface 314 .
- the board interface comprises straps or ties that are permanently attached to the positioning device.
- the straps may interface with the board by secured insertion through one or more holes or slits in the board that allow for the adjustment of the positioning device to accommodate and position variable patients.
- the board interface 314 may be a VELCRO or other hook and loop element that will engage with the softer surface of the board as in the previous aspects.
- the positioning device can be a woven device.
- the woven device must be able to non-traumatically restrain the patient and be able to flexibly accommodate the patient when the device is pulled over the patient.
- the woven device could be formed of any variety of materials.
- a non-woven positioning device may similarly surround the patient utilizing a continuous point of contact. Given the continuous point of contact formed by the positioning device in the present device, the positioning device may be further formed to contain a window 316 so that the operator has access to the patient's lower back in order to perform the procedure.
- the single device may constitute the positioning device and simultaneously serve as the support device and the inducing device.
- the positioning device may be formed to have anterior, posterior, dorsal and ventral sides.
- the anterior and posterior sides are formed to contain elastic elements 318 so as to exert force on the patient and induce a clinically preferred position for a lumbar puncture.
- the positioning device can include additional elastic elements to help induce the clinically preferred position.
- the ventral and dorsal sides of the positioning device further include semi-rigid pads 320 to leverage the force exerted by the elastic elements 318 and facilitate the induction of the clinically preferred position.
- the semi-rigid pads 320 also help the single device to support the patient as well.
- the continuous point of contact utilized in the present system provides generally equal support over the patient's entire body.
- the semi-rigid pads 320 provide increased support to select areas of the patient's body.
- the support pads may define the lumbar access area. Further aspects may utilize non-woven single device positioning device or different materials to adjust the relative support over the patient's body.
- the present system envisions the utilization of different materials, tension of elastic elements, and inclusion of pads and other elements to support and induce the correct position of the patient.
Abstract
Description
Claims (8)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/045,331 US8393329B2 (en) | 2008-09-10 | 2011-03-10 | Pediatric lumbar puncture positioning device |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US19159208P | 2008-09-10 | 2008-09-10 | |
PCT/US2009/056528 WO2010030791A2 (en) | 2008-09-10 | 2009-09-10 | Pediatric lumbar puncture positioning device |
US13/045,331 US8393329B2 (en) | 2008-09-10 | 2011-03-10 | Pediatric lumbar puncture positioning device |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2009/056528 Continuation WO2010030791A2 (en) | 2008-09-10 | 2009-09-10 | Pediatric lumbar puncture positioning device |
Publications (2)
Publication Number | Publication Date |
---|---|
US20110214677A1 US20110214677A1 (en) | 2011-09-08 |
US8393329B2 true US8393329B2 (en) | 2013-03-12 |
Family
ID=42005740
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/045,331 Expired - Fee Related US8393329B2 (en) | 2008-09-10 | 2011-03-10 | Pediatric lumbar puncture positioning device |
Country Status (2)
Country | Link |
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US (1) | US8393329B2 (en) |
WO (1) | WO2010030791A2 (en) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20120246830A1 (en) * | 2011-03-31 | 2012-10-04 | Hornbach David W | Footboard egress design |
US20130074264A1 (en) * | 2011-08-22 | 2013-03-28 | Bharat Shah | Positioning Device And Method Of Use |
US20190015240A1 (en) * | 2011-11-22 | 2019-01-17 | Andrew Wheeler | Stabilization System |
Families Citing this family (7)
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US9522078B2 (en) * | 2007-07-20 | 2016-12-20 | Fox Chase Cancer Center | Patient positioning system and method for positioning a patient during a surgical procedure |
CN109549809B (en) * | 2019-01-22 | 2021-11-05 | 青岛市妇女儿童医院 | Pediatric examination device |
CN109589241A (en) * | 2019-01-22 | 2019-04-09 | 黄东力 | A kind of department of general surgery's clinical operation positioning device |
CN110448430A (en) * | 2019-09-11 | 2019-11-15 | 广州市妇女儿童医疗中心 | Lumbar puncture lateral position arranging apparatus |
CN111920631A (en) * | 2020-09-06 | 2020-11-13 | 姜杰 | Children infusion puncture platform |
CN112618232A (en) * | 2020-12-18 | 2021-04-09 | 河南省中医院(河南中医药大学第二附属医院) | Multi-functional puncture platform of paediatrics |
CN113842289B (en) * | 2021-09-26 | 2023-04-25 | 中国人民解放军陆军军医大学第一附属医院 | Multifunctional automatic lumbar puncture bed |
Citations (6)
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---|---|---|---|---|
US3933154A (en) | 1974-01-15 | 1976-01-20 | Cabansag Edwin M | Immobilizer device |
US4660552A (en) * | 1984-09-14 | 1987-04-28 | Latham Philip B | Restraining device for spinal taps |
US5289603A (en) | 1992-06-26 | 1994-03-01 | Noboru Kumagai | Medical bed with device for retaining patient |
US5950627A (en) * | 1996-12-24 | 1999-09-14 | Laerdal Medical Corporation | Spine board |
US6308712B1 (en) * | 2000-06-23 | 2001-10-30 | Fredrick C. Shaw | Immobilizing apparatus having a sterile insert |
US6966087B2 (en) | 2001-09-12 | 2005-11-22 | Lydia Marie Robinette | Pediatric immobilizer |
-
2009
- 2009-09-10 WO PCT/US2009/056528 patent/WO2010030791A2/en active Application Filing
-
2011
- 2011-03-10 US US13/045,331 patent/US8393329B2/en not_active Expired - Fee Related
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3933154A (en) | 1974-01-15 | 1976-01-20 | Cabansag Edwin M | Immobilizer device |
US4660552A (en) * | 1984-09-14 | 1987-04-28 | Latham Philip B | Restraining device for spinal taps |
US5289603A (en) | 1992-06-26 | 1994-03-01 | Noboru Kumagai | Medical bed with device for retaining patient |
US5950627A (en) * | 1996-12-24 | 1999-09-14 | Laerdal Medical Corporation | Spine board |
US6308712B1 (en) * | 2000-06-23 | 2001-10-30 | Fredrick C. Shaw | Immobilizing apparatus having a sterile insert |
US6966087B2 (en) | 2001-09-12 | 2005-11-22 | Lydia Marie Robinette | Pediatric immobilizer |
Non-Patent Citations (1)
Title |
---|
Written Opinion dated Apr. 29, 2010; email sent to WIPO dated Jun. 3, 2011; email response from WIPO dated Jun. 6, 2011; email sent to ISA/KR dated Jun. 6, 2011; email response from ISA/KR dated Jun. 8, 2011. |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20120246830A1 (en) * | 2011-03-31 | 2012-10-04 | Hornbach David W | Footboard egress design |
US20130074264A1 (en) * | 2011-08-22 | 2013-03-28 | Bharat Shah | Positioning Device And Method Of Use |
US8763177B2 (en) * | 2011-08-22 | 2014-07-01 | Mercy Medical Research Institute | Positioning device and method of use |
US20140289963A1 (en) * | 2011-08-22 | 2014-10-02 | Mercy Medical Research Institute | Positioning Device And Method Of Use |
US9597247B2 (en) * | 2011-08-22 | 2017-03-21 | Mercy Medical Research Institute | Positioning device and method of use |
US20190015240A1 (en) * | 2011-11-22 | 2019-01-17 | Andrew Wheeler | Stabilization System |
US10588808B2 (en) * | 2011-11-22 | 2020-03-17 | Andrew Wheeler | Stabilization system |
Also Published As
Publication number | Publication date |
---|---|
WO2010030791A2 (en) | 2010-03-18 |
WO2010030791A3 (en) | 2010-07-29 |
US20110214677A1 (en) | 2011-09-08 |
WO2010030791A9 (en) | 2010-06-10 |
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